scholarly journals Survival Analysis of 3 Different Age Groups and Prognostic Factors among 402 Patients with Skeletal High-Grade Osteosarcoma. Real World Data from a Single Tertiary Sarcoma Center

Cancers ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 486
Author(s):  
Richard E. Evenhuis ◽  
Ibtissam Acem ◽  
Anja J. Rueten-Budde ◽  
Diederik S. A. Karis ◽  
Marta Fiocco ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Medical Center ◽  
Age Groups ◽  
High Grade ◽  
Real World Data ◽  
Poor Overall Survival ◽  
Histopathological Response ◽  
Curative Intent ◽  
Entire Cohort ◽  
High Grade Osteosarcoma

Age is a known prognostic factor for many sarcoma subtypes, however in the literature there are limited data on the different risk profiles of different age groups for osteosarcoma survival. This study aims to provide an overview of survival in patients with high-grade osteosarcoma in different age groups and prognostic variables for survival and local control among the entire cohort. In this single center retrospective cohort study, 402 patients with skeletal high-grade osteosarcoma were diagnosed and treated with curative intent between 1978 and 2017 at the Leiden University Medical Center (LUMC). Prognostic factors for survival were analyzed using a Cox proportional hazard model. In this study poor overall survival (OS) and event-free survival (EFS) were associated with increasing age. Age groups, tumor size, poor histopathological response, distant metastasis (DM) at presentation and local recurrence (LR) were important independent prognostic factors influencing OS and EFS. Differences in outcome among different age groups can be partially explained by patient and treatment characteristics.

scholarly journals A Pharmacological Analysis of the Activity and Failure of the Medical Treatment of High-Grade Osteosarcoma

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 141
Author(s):  
Alessandro Comandone ◽  
Antonella Boglione ◽  
Tiziana Comandone ◽  
Fausto Petrelli
Keyword(s):  
Bone Cells ◽  
Age Groups ◽  
The Elderly ◽  
New Drugs ◽  
High Grade ◽  
Secondary Resistance ◽  
Orthopedic Surgeons ◽  
Close Cooperation ◽  
High Grade Osteosarcoma ◽  
Effective Drugs

Osteosarcomas (OSs) are a group of neoplasms originating from bone cells, usually presenting in three specific age groups: children, young adults, and the elderly. High-grade OS is an extremely malignant tumor mainly due to evolution into metastatic disease, usually in the lungs. Survival of these patients has improved since the 1980s thanks to close cooperation between oncologists, oncological surgeons and orthopedic surgeons. Unfortunately, no progress has been made in the last 30 years and new, more effective drugs are needed. This article reviews the biological and pharmacological basis of the treatment of OS. Models of clinical pharmacology of the active drugs, toxic effects and reasons for primary and secondary resistance to old and new drugs are discussed.

Follicular large-cell lymphoma: intermediate or low grade?

1994 ◽  
Vol 12 (7) ◽  
pp. 1349-1357 ◽  
Author(s):  
N L Bartlett ◽  
M Rizeq ◽  
R F Dorfman ◽  
J Halpern ◽  
S J Horning
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Medical Center ◽  
Performance Status ◽  
Survival Rates ◽  
Large Cell ◽  
Poor Performance Status ◽  
Low Grade ◽  
Curative Intent ◽  
Overall Survival Rates

PURPOSE To evaluate the benefit of anthracycline-based chemotherapy, identify prognostic factors, and determine the value of the International Prognostic Factors Index for patients with follicular large-cell (FLC) lymphoma. PATIENTS AND METHODS This retrospective study includes 96 patients with FLC lymphoma treated at Stanford University Medical Center between 1969 and 1991. Fifty-five patients received doxorubicin plus cyclophosphamide-containing chemotherapy regimens, 21 patients received other chemotherapy regimens, 15 patients received radiotherapy only, and five patients received no initial therapy. Thirty-four patients had stage I or II disease and 62 patients had stage III or IV disease. RESULTS With a median follow-up duration of 5.2 years (range, 1 to 18), the actuarial 5- and 10-year overall survival rates were 75% and 54%, with actuarial 5- and 10-year freedom from progression (FFP) rates of 53% and 42%, respectively. Patients treated with chemotherapy regimens that contained both doxorubicin and cyclophosphamide had a superior actuarial 10-year FFP rate (55% v 25%, P = .06) and overall survival rate (65% v 42%, P = .04) compared with patients treated with other chemotherapy regimens. Only one patient treated with doxorubicin plus cyclophosphamide relapsed after 3 years. In the multivariate analysis, discordant lymphoma and treatment with chemotherapy regimens not containing both cyclophosphamide and doxorubicin predicted for worse FFP and overall survival rates. In addition, poor performance status and increasing areas of diffuse histology predicted for a worse survival, while anemia and male sex predicted for a worse FFP. The age-specific International Index was useful in predicting outcome; however, few patients with FLC lymphoma had high-risk features. CONCLUSION The plateau in FFP implies that patients with FLC lymphoma enjoy sustained remissions after standard anthracycline-based chemotherapy. FLC lymphoma should continue to be approached as an intermediate-grade lymphoma with curative intent.

Influence of prognostic factors in pediatric high-grade osteosarcoma survival.

2011 ◽  
Vol 29 (15_suppl) ◽  
pp. 9572-9572
Author(s):  
A. Castellanos-Toledo ◽  
R. Rivera-Luna ◽  
R. Cardenas-Cardos ◽  
J. d. J. Figueroa Carbajal ◽  
C. A. Leal-Cavazos
Keyword(s):  
Prognostic Factors ◽  
High Grade ◽  
High Grade Osteosarcoma

Patient (pt) characteristics, treatment patterns, outcomes and prognostic factors in plasmacytoid urothelial carcinoma (PUC).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e16007-e16007 ◽  
Author(s):  
Leonidas Nikolaos Diamantopoulos ◽  
Ali Raza Khaki ◽  
Funda Vakar-Lopez ◽  
Maria S. Tretiakova ◽  
John L. Gore ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Cox Regression ◽  
Treatment Patterns ◽  
Treatment Modalities ◽  
Chi Square ◽  
Peritoneal Disease ◽  
Curative Intent ◽  
Positive Margins ◽  
Entire Cohort ◽  
Pn Stage

e16007 Background: PUC is uncommon and highly aggressive, with limited data on treatment patterns, outcomes and prognostic factors. We hypothesized that PUC is associated with clinical under-staging, poor outcomes and lack of chemotherapy (CT) response. Methods: We conducted a retrospective review of pts with UC and plasmacytoid component (PUC), seen in our institution (2000 - 2018). Demographic and clinicopathologic data, treatment modalities, pathologic complete/partial response (pCR, pPR) to neoadjuvant CT (NAC), and overall survival (OS) from diagnosis and surgery (Sx) were captured. T-test, chi-square, and Cox-regression were used to explore potential prognostic associations. OS was estimated with KM method. Results: We identified 63 consecutive pts (51 men) with available data for analysis. Median age at diagnosis was 67 (44-89). During initial diagnostic workup, 32 (51%) pts had extravesical disease (cT3:24, cT4:8) and 23 (36.5%) hydronephrosis at imaging. Overall, 39 (62%) pts underwent Sx with curative intent, 25 (39.6%) were pre-treated with cisplatin-based NAC; adjuvant CT was given to 15 (24%). The remaining pts pursued bladder-sparing and/or palliative approaches. At time of Sx, 17/39 (43.6%) pts had pathologic upstaging, 10 (25.6%) had positive margins and 19 (48.7%) pN+ stage. In the NAC pt subset (25 pts), 5 (20%) had progression on scans, 19 (76%) had Sx; 2 pts had pCR (10.5%), 1 had pPR, 6 (31.5%) had pathologic upstaging. In the entire cohort, median follow-up was 8 months. Median OS was 20.7 months from diagnosis and 23.6 months from Sx. NAC was not significantly associated with longer OS (from Sx) (HR 1.53, 95%CI 0.16-15, p = 0.715) and the same was true for adjuvant CT (HR 0.64, 95%CI 0.1-4, p = 0.630). 15/39 pts recurred after Sx (38.4%), with 9/15 (60%) having peritoneal/retroperitoneal involvement. Conclusions: PUC frequently presented with advanced stage at diagnosis and demonstrated poor NAC response, frequent upstaging, positive margins and pN+ stage at Sx. More than half of patients who recurred after Sx, presented with (retro)peritoneal disease. Studies evaluating molecular biomarkers and drivers in PUC, and prospective clinical trials are being pursued.

scholarly journals Characteristics and prognostic factors of age-stratified high-grade intracranial glioma patients: A population-based analysis

2019 ◽  
Author(s):  
Yun Sun ◽  
Zhi-yong Xiong ◽  
Peng-fei Yan ◽  
Liang-lei Jiang ◽  
Chuan-sheng Nie ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Survival Data ◽  
Age Groups ◽  
High Grade Glioma ◽  
Population Based ◽  
High Grade ◽  
Treatment Protocols ◽  
Cox Models ◽  
Cause Specific Survival

We evaluated characteristics and different prognostic factors for survival in age-stratified high-grade glioma in a US cohort. Eligible patients were identified in the Surveillance, Epidemiology, and End Results (SEER) registries and stratified into 3 age groups: 20-39 years old (1,043 patients), 40-59 years old (4,503 patients), and >60 years old (5,045 patients). Overall and cancer-related survival data were obtained. Cox models were built to analyze the outcomes and risk factors. It showed that race was a prognostic factor for survival in patients 40 to 59 years old and in patients ≥60 years old. Partial resection was associated with lower overall survival and cause-specific survival in all age groups (overall survival: 20-39 yr: HR=6.41; 40-59 yr: HR=4.84; >60 yr: HR=5.06; cause-specific survival: 20-39 yr: HR=5.87; 40-59 yr: HR=4.01; >60 yr: HR=3.36). The study highlights that, while some prognostic factors are universal, others are age-dependent. The effectiveness of treatment approaches differs for patients in different age groups. Results of this study may help to develop personalized treatment protocols for glioma patients of different ages.

scholarly journals Death domain-associated protein (DAXX) expression is associated with poor survival in metastatic high-grade serous carcinoma

2020 ◽  
Vol 477 (6) ◽  
pp. 857-864
Author(s):  
Ben Davidson ◽  
Erin McFadden ◽  
Arild Holth ◽  
Marta Brunetti ◽  
Vivi Ann Flørenes
Keyword(s):  
Cell Lines ◽  
Western Blotting ◽  
Serous Carcinoma ◽  
High Grade ◽  
Death Domain ◽  
Poor Overall Survival ◽  
Clinical Role ◽  
Entire Cohort ◽  
Clinicopathologic Parameters

AbstractThe objective of this study was to analyze the expression and clinical role of mitosis regulators α-thalassemia/mental retardation syndrome X-linked (ATRX) and death-domain-associated protein (DAXX) in metastatic high-grade serous carcinoma (HGSC). ATRX and DAXX protein expression by immunohistochemistry was analyzed in 400 HGSC effusions. DAXX expression was additionally studied in 15 cancer cell lines, including 4 ovarian carcinoma lines, and in 81 of the 400 HGSC effusions using Western blotting. ATRX and DAXX were expressed in HGSC cells in 386/400 (96%) and 348/400 (87%) effusions, respectively. Western blotting showed DAXX expression in all 15 cell lines and in 70/81 (86%) HGSC effusions. DAXX expression by immunohistochemistry was higher in pleural compared to peritoneal effusions (p = 0.006) and in post-chemotherapy compared to pre-chemotherapy effusions (p = 0.004), and its expression was significantly associated with poor overall survival in univariate of the entire cohort (p = 0.014), as well as analysis limited to chemo-naïve effusions tapped at diagnosis (p = 0.038). The former association retained its prognostic role in Cox multivariate survival analysis (p = 0.011). ATRX expression was unrelated to clinicopathologic parameters or survival. In conclusion, DAXX is associated with disease progression and could be a prognostic marker in metastatic HGSC. Silencing this molecule may have therapeutic relevance in this cancer.

Do Results From Clinical Trials in Acute Myeloid Leukemia Reflect Clinical Reality? A Danish National Cohort Study of 813 Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1477-1477
Author(s):  
Lene Sofie Granfeldt Ostgard ◽  
Mette Nørgaard ◽  
Henrik Sengeløv ◽  
Lars Kjeldsen ◽  
Lone S. Friis ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Prognostic Factors ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Age Groups ◽  
Age Group ◽  
Curative Intent ◽  
Protocol Group ◽  
Co Morbidity ◽  
Underrepresentation Of Women

Abstract Abstract 1477 Previous studies have documented the underrepresentation of women and elderly patients in American clinical trials of leukemia. If, characteristics of patients included in clinical protocols differ markedly from the characteristics of the majority of patients treated outside protocols the external validity of clinical trials may be threatened. Methods: The Danish National Acute Leukaemia Database (ALDB) includes detailed data on a large well-defined non-selected population of 2729 AML patients (covering >95% of AML patients diagnosed since Jan 2000). Since 2000 Danish AML patients have been included in 3 different British protocols (AML15, 16 and 17). We analysed a cohort of 2624 patients diagnosed with AML in Denmark since Jan. 2000 (105 APL-patients were excluded). We compared patients treated with curative intent according to the British protocols with patients treated with curative intent off-protocol with regard to characteristics, possible prognostic factors, CR-rate, and survival. For comparable groups we divided patients into 2 age groups (<60 and ≥60 years) and further excluded patients diagnosed before protocol inclusion was possible for the given age group. Results: 813 patients were treated with curative intent (517 pts < 60 years (96% of all patients <60y) vs. 296 pts ≥60 year, (35 % of all patients >60y). Of these, 391 pts (232 pts <60 years, 44.9 % vs. 159 pts ≥60 years, 53.7 %) were treated according to protocols. For both age groups WHO performance status score (WHO PS) was found to be significantly lower in the on-protocol group. Presence of secondary AML (sAML) was found more frequent in the off-protocol groups, but was only statistically significant in the group under 60 years. In patients 60 years or older, a significantly higher LDH-level and WBC was found in the on-protocol groups. We did not find any difference in distribution of sex, age, cytogenetic changes, presence of extra medullary leukemia (EML) or blast counts. Allogeneic transplantation (alloHCT) was significantly more often performed in the protocol groups (table 1). For patients under 60 years of age overall survival (OS) was superior in the on-protocol group (fig. 1). For the older age group OS was similar in the on- and off-protocol group (fig. 2). After controlling for possible prognostic factors protocol participation seemed to be associated with longer OS in patients under 60 years (HR 0.66, 95%CI 0.48–0.99, p=0.02), but not in patients 60 years or older (HR 1.17, 95%CI 0.87–1.57). The unevenly distributed characteristics; LDH-level, sAML, WHO PS, performance of alloHCT were all found to be of significant importance to OS. Conclusions: AML patients included in the British AML trials in Denmark had a more favorable profile than patients treated with standard regimens. We found a superior survival in on-protocol patients under 60 years. This could not be fully explained by an uneven distribution of prognostic factors. A beneficial effect of the protocol treatments and confounding by co-morbidity are suggested. Population-based studies may thus have an important role in examining some aspects of prognosis in AML. In this context the Danish ALDB has proven to be a valuable data source. Disclosures: No relevant conflicts of interest to declare.

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